Provider Demographics
NPI:1073276648
Name:BARCENES, STEVEN ADAM (BCBA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ADAM
Last Name:BARCENES
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4862 W MYSTIC COVE WAY
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83714-4785
Mailing Address - Country:US
Mailing Address - Phone:805-791-6791
Mailing Address - Fax:
Practice Address - Street 1:3076 N FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-5215
Practice Address - Country:US
Practice Address - Phone:208-376-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst